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Contact Information

GWENETH M DOUGLAS, APRN
675 TOWER AVE STE 301
HARTFORD, CT06112-1274
 Phone: 860-714-8275
 Fax: 860-714-8591
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychiatric/Mental Health

163WP0808X
Indicates primary specialty

NPI Profile & details for GWENETH M DOUGLAS · (Female)

NPI Number 1083172811
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 03/11/2019
Last updated 06/30/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 7942
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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